A sign marks the entrance to the Edward Hines Jr. VA Hospital on May 30, 2014 in Hines, Illinois. Hines, in suburban Chicago, has been linked to allegations that administrators kept secret waiting lists at Veterans Administration hospitals so hospital executives could collect bonuses linked to meeting standards for rapid treatment. Today, as the scandal continued to grow, Veterans Affairs Secretary Eric Shinseki apologized in public and then resigned from his post. (Photo by Scott Olson/Getty Images)

WASHINGTON — Staff members at dozens of Department of Veterans Affairs hospitals across the country have objected for years to falsified patient appointment schedules and other improper practices, only to be rebuffed, disciplined or even fired after speaking up, according to interviews with current and former staff members and internal documents.

The growing VA scandal over long patient wait times and fake scheduling books is emboldening hundreds of employees to go to federal watchdogs, unions, lawmakers and outside whistle-blower groups to report continuing problems, officials for those various groups said.

In interviews with the New York Times, a half-dozen current and former staff members — four doctors, a nurse and an office manager in Delaware, Pennsylvania and Alaska — said they faced retaliation for reporting systemic problems. Their accounts, some corroborated by internal documents, portray a culture of silence and intimidation within the department and echo experiences detailed by other VA personnel in court filings, government investigations and congressional testimony, much of it largely unnoticed until now.

The department has a history of retaliating against whistle-blowers, which Sloan Gibson, the acting VA secretary, acknowledged this month at a news conference in San Antonio. “I understand that we’ve got a cultural issue there, and we’re going to deal with that cultural issue,” said Gibson, who replaced Eric Shinseki after Shinseki resigned last month. Punishing whistle-blowers is “absolutely unacceptable,” Gibson said.

The federal Office of Special Counsel, which investigates whistle-blower complaints, is examining 37 claims of retaliation by VA employees in 19 states and recently persuaded the VA to drop discipline actions against three staff members who had spoken out. Together with reports to other watchdog agencies and the Times interviews, the accounts by VA whistle-blowers cover several dozen hospitals, with complaints dating back seven years or longer.

Dr. Jacqueline Brecht, a former urologist at the Alaska VA Healthcare System in Anchorage, said in an interview that she had a heated argument with administrators at a staff meeting in 2008 when she objected to using phantom appointments to make wait times appear shorter, as they had instructed her. She said the practice amounted to medical fraud, and she complained about other patient care problems as well.

Days later, a top administrator put Brecht on administrative leave and had security officers walk her out of the building.

“It’s scary to think that people can try to stand up and do the right thing, and this is the reaction,” said Brecht, now in private practice in Massachusetts.

Her complaints were corroborated by other Alaska personnel

Cynthia Joe, the chief of staff at the Alaska VA Healthcare System, said that the facility had never used phantom scheduling and that, while some staff members had raised questions about scheduling practices, no one had protested or faced discipline after raising concerns.

In court filings detailing the VA response to other problems, Dr. Ram Chaturvedi, formerly with the Dallas VA Medical Center, said he began complaining in 2008 about shoddy patient care, including negligence by nurses who had marked the wrong kidney while preparing a patient for a procedure. In another instance, Chaturvedi said, medical personnel had brought the wrong patient to an operating table.

A supervisor told Chaturvedi to “let some things slide” because of staffing problems, but he continued writing up complaints. Officials considered him disruptive and fired him in 2010.

The Project on Government Oversight, a private group working with whistle-blowers, said it had received confidential complaints from about 175 current and former VA employees since the latest controversy began. Those complaints are of such interest to the government that the VA inspector general subpoenaed them last month, demanding all reports related to the Phoenix VA. The group is resisting because of concerns about whistle-blower confidentiality.

“People are coming out of the woodwork,” said J. Ward Morrow, a lawyer for the American Federation of Government Employees, which has received recent reports of problems from more than 100 VA employees.

Brecht, the Alaska urologist put on leave in 2008, said she thought about calling a whistle-blower’s hotline at the time, but feared administrators might take further steps to discredit her and risk her medical licensing.

“When I saw all this on the news the last few months, part of me felt this huge sense of relief,” Brecht said, “because it was like I wasn’t crazy after all.”

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